FIRST RESULTS AFTER ENDOART® IMPLANTATION FOR DECOMPENSATED ENDOTHELIUM IN GLAUCOMA PATIENTS.
Published 2024 - 28th ESCRS Winter Meeting
Reference: FP32 | Type: Submission | DOI: 10.82333/r22h-x305
Authors: Johanna Wiedemann* 1 , Simona Schlereth 1 , Mario Matthaei 1 , Claus Cursiefen 1 , Björn Bachmann 1
1Department of Ophthalmology,University of Cologne,Cologne,Germany
Purpose
The purpose of this study is to describe early results after the implantation of the novel keratoprosthesis Endoart® (EyeYon Medical, Israel, CE approved 08/21) for endothelial replacement in glaucoma patients. These patients are at very high risk for secondary graft failure soon after endothelial transplantation (DMEK or DSAEK). This novel artificial endothelial prosthesis acts as a barrier for aqueous humor and might allow a permanent stabilization of the corneal edema.
Setting
All patients who underwent implantation of the keratoprosthesis EndoArt® at the university of Cologne, department of ophthalmology starting July 2023 were retrospectively analysed.
Methods
Glaucoma patients after implantation of the keratoprosthesis EndoArt® were retrospectively analysed. During surgery the prosthesis was positioned on the posterior stroma and secured by a gas bubble and transcorneal sutures. In this first analysis we investigated the need for additional gas injections into the anterior chamber (rebubbling) as well as changes in visual acuity and corneal thickness (anterior segment OCT) within the first 6 weeks after surgery.
Results
A series of seven glaucoma patients in which EndoArt® implantation was performed were included in this analysis. All patients had undergone multiple glaucoma surgeries, and 4 patients have experienced multiple DMEK procedures. Four patients previously had the implantation of a glaucoma drainage device. Five patients were pseudophakic, and two were aphakic. Four patients received C3F8 12%, and three received SF6 20% for the attachment of EndoArt.
43% (3 eyes) needed at least one rebubbling, 2 patients (29%) needed two rebubblings and one patient (14%) received three rebubblings. In this small series only patients who initially received SF6 20% needed repetitive rebubbling.
Mean preoperative visual acuity was logMAR 1.8 (SD ± 0.2). Three to six weeks postoperatively the mean visual acuity improved to logMAR 1.5 (SD ± 0.6). The mean preoperative central corneal thickness (CCT) was 833.5 microns (SD ± 206). The corneal thickness decreased in all patients. The mean CCT 3-6 weeks postoperatively decreased to 714,8 microns (SD ± 261.5). Preoperatively, patients complained of discomfort and foreign body sensation; some described pain. Postoperatively, all patients reported a decrease in these symptoms.
Conclusion
EndoArt® led to corneal deswelling and improvement of visual acuity in glaucoma patients. The major complication after EndoArt® implantation in our cohort was rebubbling. The use of C3F8 12% appears to improve the overall rebubbling rate.
Early results suggest that patients at high risk for graft failure after DMEK or DSAEK may benefit from this therapy. However, long-term results in this patient group are still pending.